Statistical analysis for prognosis of Hodgkin’s lymphoma in teenagers and young adult patients

Purpose. The purpose of the study was the creation of Hodgkin’s lymphoma (HL) predictive model in patients at the age of 10-29 years with a multivariant analysis. Material and methods. Data of 203 patients aged from 10 to 29 years were included in the study, there were 106 teenagers 10-17 years old (52 %) and 97 young adults 18-29 years old (48 %). Stage I was diagnosed in 7 patients (3.4 %), stage II - in 81 (39.9 %), stage III - in 55 (27.1 %) and stage IV-in 60 patients (29.6 %). Nodular sclerosis is established in majority of patients (82.8 %). Almost in half of cases (48.3 %) the B-symptoms were noted. Bulky disease was diagnosed in 152 (74.9 %) patients. Patients of 10-17 years were treated according to risk-adapted therapy DAL-HD (38.8 %) and SPbHL (54.3 %). Young adults of 18-29 years received treatment according to the ABVD and BEACOPP regimen (49.4 % and 37.1 %, respectively). To 66 % patients radiation therapy was carried out. Results. 5-year overall survival was 80.5 ± 3.6 %, disease-free survival was 78.8 ± 3.7 %, event-free survival was 65.4 ± 4.2 %; 10-year overall, disease-free and event-free survival were 70.3 ± 5.3 %, 68.1 ± 5.4 % and 61.1 ± 4.6 %, respectively. Nineteen factors underwent the statistical analysis. For predictors with several values the optimum cut-off was defined. Ten factors showed the significant influence on outcomes: the age more than 16 years old (AUC = 0.646; р = 0.0281), stage IV (AUC = 0.716; р = 0.0001), B- and b-symptoms, number of involved zones more than five (AUC = 0.633; р = 0.0202), lung, bone marrow, thymus and pleura injury, tumor volume more than 103.1 cm³/ m² (AUC = 0.610; р = 0.027). The age of the patient and stage became the most important predictors in Cox hazard model. Thus, present variables in Cox hazard model will correspond to certain numerical and graphic characteristics of survival that allows to estimate risks and to decide on the treatment. Conclusion. Therapy for Hodgkin in teenagers and young adults based on stratification on risk groups depending on un-favoufable risk factors, carrying out multicenter researches will allow achieving the best treatment results and decrease remote consequences in patients at the age of 10-29 years old.

teenagers, young adult, Hodgkin s lymphoma, multivariant analysis, Cox hazard model